A national partnership brings a much-needed nutrition program to rec departments.

Although park and recreation departments inherently provide heart-healthy activities such as basketball, tennis and swimming, many health experts contend that recreation and other community organizations should do more to improve the health of both children and adults.

With its numbers of overweight children and adolescents (as well as obese adults) having doubled over the past two decades, the United States faces a serious health crisis. Obesity substantially raises the risk of illness from high cholesterol, high blood pressure, type-2 diabetes, heart disease, stroke, gallbladder disease and several types of cancer. Researchers know this information to be true, but very few park and recreation departments have implemented programs targeting these health concerns.

Until now. Health experts can breathe a collective sigh of relief as resource books and videos detailing a new nutrition program are being distributed this month to the approximately 200 park and recreation departments that have requested the materials. The new community-based program, Hearts N' Parks, developed and supported by a partnership between the National Heart, Lung and Blood Institute (NHLBI) and the National Recreation and Park Association (NRPA), is designed to reduce the growing trend of obesity and the risk of coronary heart disease.

"Hearts N' Parks is unique in that it is the first national grassroots program for cardiovascular disease intervention that is designed specifically for the recreation and park setting," says Kathy Spangler, director of national programs at the NRPA. "All that research wasn't getting translated into programming, so we've been positioning ourselves to be a catalyst at the community level to help mobilize the health agenda."

It appears that park and recreation departments are more than happy to be mobilized. In summer 1999, the program was piloted in 12 North Carolina communities involving 33 sites and more than 2,000 participants. In July 2000, a second pilot was launched in Arlington County, Va., with nearly 300 people attending the kickoff event, including U.S. Surgeon General David Satcher.

The Arlington program, implemented in about 10 sites throughout the community, has already debuted within the departments' after-school programs for elementary-aged children, kids' summer camps, and senior-adult programs. The Hearts N' Parks program is not designed to be used as an isolated program. It is meant to be utilized as a supplement to other recreation programs, and it should ideally be able to take on various forms. "It's about fusing health promotion into recreation resource programming," Spangler says, "so it's really about adding value to existing programs."

The North Carolina communities have supplemented their teen and pre-teen youth basketball games by providing a table full of free fruit and sports drinks, as well as health and nutrition materials for participants to read. "The kids really like it, and the parents like it too," says Carol Moore, coordinator for staff development at the Raleigh (N.C.) Park and Recreation Department. "In some cases, it seems like the parents are learning along with the kids."

The Arlington County communities have also created supplements for their kids' programs, including 3D models of the food pyramid and test tubes filled with the different quantities of fat in various foods. For instance, a test tube filled with the amount of fat in a McDonald's small order of fries is compared with another test tube filled with the amount of fat in one serving of yogurt. "It's educational, but with kids, you've got to find a way to make it fun," says Jennifer Martin, wellness programmer for the Arlington (Va.) Department of Parks, Recreation and Community Resources, "because if it's fun, then you can say, 'Oh yeah, by the way, it's good for you, too.' "

Other extensions of the program in Arlington include a healthy cooking class for families, a vegetarian Thanksgiving activity, healthy-lifestyles and weightmanagement classes and a wellness lending library, which provides Hearts N' Parks materials for recreation programmers to use as a resource when incorporating the program into their curricula. These types of classes and activities are just part of what the resource book outlines. The book focuses on five "P's": people, programs, public visibility, partnerships and performance indicators.

The "people" branch encourages recreation departments to be aware of new participants, nonparticipants, high-risk populations and different stages of behavior and change. The activities under way in both North Carolina and Arlington County fall under the "programs" category, which will vary within each park and recreation department. Videos created by the NHLBI, along with press releases and fact sheets with general information and statistics about health issues in the United States, were distributed to the departments. These resources, available in both English and Spanish, are examples of public visibility because they provide information for education and distribution to diverse population groups.

Working with others is another important part of the Hearts N' Parks program, which is why it also emphasizes the need for partnerships. The program provides lists of potential partners, letters to send to potential partners and agendas for meetings once a partnership has been formed. In one North Carolina county, a department has partnered with its local hospital to hold weekly "walk-abouts," in which people walk through small towns, looking at historic markers. After the walk-abouts, the hospital provides information about healthy eating and the value of walking, as well as blood pressure screenings.

The Arlington County park and recreation departments have partnered both with a local hospital, which provides screenings and health education, and local Whole Foods markets, which provide instructors for cooking classes. Performance indicators take the form of pre- and post-tests that focus on a person's knowledge of nutrition and physical activity, as well as a person's behavior with regard to these issues.

An example of a pre-test question is, "If you were at the movies, which one would you pick-popcorn with salt or butter or popcorn without salt or butter?" The post-test is designed to record whether the program changed the person's knowledge of and behavior regarding these lifestyle choices.

The North Carolina pilots have been able to show a clear improvement among both youths and adults through their pre- and post-test results. An evaluation reveals that participants retain information about hearthealthy behaviors and intend to eat healthier.

Seniors report feeling healthier and experiencing less day-to-day pain following the program. "The program has given us a good tool for evaluation," says Moore. "We've always known that the activities we provide are beneficial, but this has made it so that we can prove that the program is beneficial. For example, we can prove that kids have learned more about healthy eating." But, Moore adds, it's the positive feedback the department has received from kids, parents and coaches that is the most rewarding.

The Hearts N' Parks program has the potential to be rewarding to many people, especially those at high risk for illness associated with being overweight or obese. Because the program is designed to be an addition to park and recreation departments at the local level, the hope is that it will start to close the gap between scientists' research and community programming.

At the very least, the program may help park and recreation department officials broaden the scope of their programs and learn to design their programs with a nutritionbased, heart-healthy angle in mind. "The program is about helping people live healthy lives," says Spangler. "It's about helping transform the industry to serve more than just the 20 percent who are naturally motivated for physical activity."